Health

Health
Theme
Pillar	Citizen's Lives

Health (Kiswahili: Afya) is a theme of the Citizen's Lives pillar. It covers the coast's hospitals, clinics and community health services, the people who staff them, how care is paid for, and health outcomes. Outcomes vary widely along the coast: in the 2022 Kenya Demographic and Health Survey, 95.7 per cent of recent births in Taita-Taveta were delivered by a skilled provider, against 59.2 per cent in Tana River. Kilifi had the highest share of stunted children under five of any county in Kenya, at 37.0 per cent.

What this page is for

This is the shared page for health on the coast: please add the projects, organisations, data and stakeholder views you know about, so that everyone can read them side by side.

Health on the coast today

In the 2022 survey, the share of recent births delivered by a doctor, nurse, midwife or clinical officer was 95.5 per cent in Mombasa, 92.5 per cent in Lamu, 89.3 per cent in Kwale and 84.5 per cent in Kilifi, against a national figure of 89.3 per cent, with Tana River far behind at 59.2 per cent. Stunting among children under five ranged from 13.5 per cent in Mombasa and 16.1 per cent in Lamu to 19.2 per cent in Taita-Taveta, 21.1 per cent in Tana River, 22.7 per cent in Kwale and 37.0 per cent in Kilifi, against 17.6 per cent nationally. Mombasa's plan reports that maternal mortality in its facilities rose from 167.5 to 192 deaths per 100,000 live births over the previous plan period, partly because of delayed referrals.

Staffing is thin everywhere. Kilifi had 1,532 health workers at the end of its last plan period, with roughly one doctor and four nurses for every 10,000 people, well short of the World Health Organization benchmarks the county cites. Taita-Taveta reports 1,542 health workers, a doctor-to-population ratio of 1 to 6,191 and a shortfall of 1,706 health personnel. Tana River gives a doctor-to-patient ratio of 1 to 13,944 and 71 functional health facilities, 48 of them government owned.

The Coast General Teaching and Referral Hospital in Mombasa is the largest health facility in the region and serves all six counties. Health insurance has historically been low: in 2022 only 26 per cent of Kenyans had any cover, and 5 per cent of those in the poorest fifth of households. Lamu paid for cover for 20,000 poor households under the old National Hospital Insurance Fund from 2018/19, which its plan says raised county coverage from 13 to 70 per cent.

Plans and policy

Healthcare is one of the five core pillars of the national Bottom-Up Economic Transformation Agenda, set out in the Fourth Medium Term Plan 2023-2027 of Kenya Vision 2030. In October 2023 four laws reshaped the system: the Primary Health Care Act organises care into primary care networks with community health promoters; the Facility Improvement Financing Act lets public facilities keep the revenue they earn; the Social Health Insurance Act replaced the National Hospital Insurance Fund with the Social Health Authority (SHA) and three new funds; and the Digital Health Act governs health data.

The county plans for 2023-2027 carry the local detail. Kilifi lists reproductive, maternal, newborn, child and adolescent health, immunisation, nutrition, community health, specialised services, the referral system, staffing and wider insurance cover among its priorities. Mombasa is seeking Level 6 (national referral) status for Coast General, alongside plans to raise its sub-county hospitals in Likoni, Port Reitz, Kongowea and Jomvu to Level 4 with intensive care.

Who is involved

Nationally, the Ministry of Health sets policy and the Social Health Authority pays claims for insured patients. The six county departments of health run public facilities from dispensaries to county referral hospitals, and the Controller of Budget reports on the claims counties are owed. The KEMRI-Wellcome Trust Research Programme, a partnership of the Kenya Medical Research Institute, the Wellcome Trust and the University of Oxford, has been headquartered in Kilifi since 1989. Non-profits such as Safari Doctors run monthly mobile clinics in remote coastal and border areas. The six counties also cooperate through the Jumuiya ya Kaunti za Pwani. Related project: Greater Mombasa Private Specialty Hospital.

Open questions

Will SHA pay what it owes? The Controller of Budget reported unpaid SHA claims to county health facilities of KES 26.87 billion at 31 March 2026, up from KES 8.29 billion three months earlier; Mombasa was owed KES 596.7 million and Kwale KES 127.3 million, while Kilifi, Lamu, Taita-Taveta and Tana River did not submit figures. Mombasa's county government put its own arrears at about KES 1.2 billion in March 2026, including KES 700 million owed to Coast General, and its health executive attributed many rejected claims to diagnoses that did not match the SHA system.

Who pays for the region's referral hospital? Mombasa's governor, Abdulswamad Sheriff Nassir, says the county funds Coast General itself with no national money, does not want a national takeover, and asks for "equity in allocation" with national referral hospitals such as Kenyatta. The views of the other five counties, whose residents are referred there, and of the Ministry of Health have yet to be added.

Can counties keep their doctors? Doctors at Coast General called a strike in early 2026, citing stalled promotions, delayed confirmations and political interference in hospital management; it was called off after the county agreed a timetable for promotions and permanent terms. Governor Nassir pledged no political interference in hospital operations. Kilifi and Taita-Taveta both describe large shortfalls against international staffing benchmarks.

Coverage the plan expects

• county health facilities
• maternal and child health
• health financing
• health workforce and staffing
• nutrition and child stunting

Projects

Greater Mombasa Private Specialty Hospital

A project page joins this theme by naming it as the theme in its infobox. To start one:

Sources

• Kenya Demographic and Health Survey 2022: Key Indicators Report, KNBS, Ministry of Health and ICF, 2023
• Kilifi County Integrated Development Plan 2023-2027, County Government of Kilifi, 2023
• Mombasa County Integrated Development Plan 2023-2027, County Government of Mombasa, 2023
• Taita Taveta County Integrated Development Plan 2023-2027, County Government of Taita Taveta, 2023
• Tana River County Integrated Development Plan 2023-2027, County Government of Tana River, 2023
• Lamu County Integrated Development Plan 2023-2027, County Government of Lamu, 2023
• Overview of new health reforms launched in Kenya in 2023, PATH, 2024
• Fourth Medium Term Plan 2023-2027, Government of Kenya, 2024